超声成像及定量分析在小儿肾积水手术指征中的应用

Application of ultrasound imaging and quantitative analysis in the indication of children with hydronephrosis

目的探讨肾脏三维超声容积成像及定量分析在小儿肾积水手术指征中的应用价值。方法采用三维超声容积成像及虚拟器官计算机辅助定量分析,检测治疗组、观察组肾盂前后径(APD)、肾实质容积(RPV)、肾盂肾盏体积(PCV)、肾脏整体体积(RV)、实质容积比(RPVR),对比两组各项数值与GFR%的相关性,分析RPVR对手术时机把握的应用价值。结果治疗组与观察组GFR%及RPVR、APD明显不同,其差异有显著性(P<0.05)。在PCV、RPV、RV、APD、RPVR中与GFR%相关性最高的为RPVR。观察组同一儿童不同年龄段的RV、RPV、PCV均明显不同(P<0.05),GFR%、RPVR无明显差异(P>0.05)。结论 PCV、RPV、RV与GFR%相关性较差,在动态评估积水严重程度时受年龄影响。而RPVR不受年龄影响且与积水程度的相关性高于RV、PCV、RPV、APD,对动态评价积水肾脏的积水严重程度有一定价值,且对手术时机的把握有一定的指导价值。

Objective To evaluate the value of three-dimensional ultrasound volume imaging and quantitative analysis in the indication of hydronephrosis in children.Methods Three-dimensional ultrasound volumetric imaging and computer-aided quantitative analysis of virtual organs were used to detect the anterior posterior diameter(APD),renal parenchyma volume(RPV),renal pelvis calyceal volume(PCV),renal integral volume(RV),renal parenchymal volume ratio(RPVR) in the treatment group and the observation group.To compare the values between the treatment group and the observation group,to observe the correlation between the values and the GFR%,and to analyze the application value of RPVR in the timing of operation.Results The GFR%,APD and RPVR of the treatment group and the conservative group were significantly different,and there was statistical difference between the treatment group and the observation group(P<0.05).RPVR has the highest correlation with GFR% in PCV,RPV,RV,APD and RPVR.The RV,RPV,PCV of the same children in the different age group was significantly different(P<0.05),but there was no significant difference in GFR% and RPVR(P>0.05).Conclusion The correlation between PCV,RPV,RV and GFR% was poor,and was influenced by age when evaluating the severity of hydronephrosis dynamically.RPVR is independent of age and has higher correlation with hydronephrosis than RV,PCV,RPV,APD,in evaluating the severity of hydronephrosis dynamically,and has a certain guiding value on the timing of operation.